Analyse pharmaceutique des prescriptions en services de rééducation neurologique PDF Download
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Author: Marie Hubault
Publisher:
ISBN:
Category :
Languages : fr
Pages : 362
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Book Description
Author: Marie Hubault
Publisher:
ISBN:
Category :
Languages : fr
Pages : 362
Get Book Here
Book Description
Author: Alix de Laval
Publisher:
ISBN:
Category :
Languages : fr
Pages : 242
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Book Description
Les patients pris en charge en services de rééducation neurologique de l'hôpital H Gabrielle présentent un traitement médicamenteux avec risque iatrogène important, nécessitant le déploiement d'activités de pharmacie clinique spécifiques. L'analyse des prescriptions est réalisée quotidiennement par un pharmacien et un interne, en collaboration avec les médecins. L'objectif est de décrire les problèmes médicamenteux détectés, les interventions pharmaceutiques (IP) réalisées et d'évaluer leur impact clinique. Une étude prospective d'avril 2010 à décembre 2011 a été menée. Les problèmes détectés/IP proposées au cours de l'analyse des prescriptions ont été analysés. Pour évaluer l'impact clinique, ont été exclues les IP concernant les substitutions de médicaments non disponibles à l'hôpital, les relais IV /per os et autres IP à impact économique exclusif. Les IP retenues ont été classées selon la famille thérapeutique. Elles ont été évaluées par un médecin et un pharmacien: impact nul (-), significatif ( + ), très significatif ( ++ ), vital ( +++ ). Les résultats, analysés en global puis selon les classe thérapeutiques ont été comparés entre les 2 évaluateurs ( chi2). Sur 9036 prescriptions analysées, 1773 IP ont été signalées (20%) dont 1369 acceptées par le prescripteur (77 %). Les principaux médicaments impliqués étaient les antalgiques (17 %), IPP/antiacides (12 %), anti-infectieux (11 %) et psychotropes (10 %). Les principaux problèmes détectés étaient des non-conformités aux référentiels (1 7%), médicaments non indiqués (17%) et problèmes de posologies (16 %). Les IP les plus fréquentes étaient les propositions d'arrêt (28 %) et d'adaptation posologique (21 %). Sur les 1773 IP, 826 ont été retenues pour évaluer l'impact clinique. Les principaux médicaments concernés étaient les antalgiques (165), anti-infectieux (140), IPP/antiacides (124), psychotropes (116) et anticoagulants (116). Le médecin a coté 1 IP -, 502 +, 323 ++. Le pharmacien a coté 9 IP -, 509 +, 308 ++ ; sans différence significative entre les 2 évaluateurs. Pour le médecin, les classes thérapeutiques avec le plus d'IP ++ étaient les anti-infectieux (74 %), anticoagulants (67 %), ions injectables (53 %), antalgiques (41 %) et psychotropes (36 %). Côté pharmacien, les ions injectables (71 %), antidiabétiques (70 %), anticoagulants (59 %), psychotropes (50 %), anti-infectieux (46 %) et antalgiques (43 %). La différence de cotation d'IP ++ entre les 2 évaluateurs était significative pour anti-infectieux (p
Author: Corinne Grenier
Publisher: John Wiley & Sons
ISBN: 1786307073
Category : Business & Economics
Languages : en
Pages : 72
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Book Description
How can healthcare systems be transformed by reimagining their multiple silos to favor processes and practices that are more responsive to local, horizontal initiatives? Altering Frontiers analyzes numerous experiences, using a multidisciplinary approach, paying attention to certain actors, collectives and organizational arrangements. Through this work, levers are identified that promote lasting transformation: recognizing the legitimacy of the practices of many who are often "invisible"; trusting those who know their intervention territory; investing in methodological support; taking advantage of tools and procedures such as instruments for strategic and managerial discussion; and developing the capacity to absorb innovative ideas and experiences that circulate within the environment.
Author: Irene Papanicolas
Publisher: McGraw-Hill Education (UK)
ISBN: 033524727X
Category : Medical
Languages : en
Pages : 418
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Book Description
International comparison of health system performance has become increasingly popular, made possible by the rapidly expanding availability of health data. It has become one of the most important levers for prompting health system reform. Yet, as the demand for transparency and accountability in healthcare increases, so too does the need to compare data from different health systems both accurately and meaningfully. This timely and authoritative book offers an important summary of the current developments in health system performance comparison. It summarises the current state of efforts to compare systems, and identifies and explores the practical and conceptual challenges that occur. It discusses data and methodological challenges, as well as broader issues such as the interface between evidence and practice. The book draws out the priorities for future work on performance comparison, in the development of data sources and measurement instruments, analytic methodology, and assessment of evidence on performance. It concludes by presenting the key lessons and future priorities, and in doing so offers a rich source of material for policy-makers, their analytic advisors, international agencies, academics and students of health systems.
Author: Marie-Pascale Pomey
Publisher: Springer Nature
ISBN: 3030141012
Category : Medical
Languages : en
Pages : 317
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Book Description
Patient-oriented approaches to healthcare management have been brought to the fore in recent years, yet this book underlines how even further change is needed in order to fully mobilise the experiential knowledge of patients, and ultimately improve our healthcare systems. With contributions from scholars and patients across the globe, this collection brings together a comprehensive overview of major achievements in patient engagement, analysing political, organizational and clinical contexts. By understanding the concept of care partnership, the authors explore how this patient revolution could transform, improve and innovate the ways in which care services are organized and delivered. Looking closely at the role of new technologies, this timely book will undoubtedly be of use to patients, managers and professionals within the healthcare industry, as well as those researching health policy and organization.
Author: Eric Topol
Publisher: Basic Books
ISBN: 0465094473
Category : Medical
Languages : en
Pages : 386
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Book Description
The essential guide by one of America's leading doctors to how digital technology enables all of us to take charge of our health A trip to the doctor is almost a guarantee of misery. You'll make an appointment months in advance. You'll probably wait for several hours until you hear "the doctor will see you now"-but only for fifteen minutes! Then you'll wait even longer for lab tests, the results of which you'll likely never see, unless they indicate further (and more invasive) tests, most of which will probably prove unnecessary (much like physicals themselves). And your bill will be astronomical. In The Patient Will See You Now, Eric Topol, one of the nation's top physicians, shows why medicine does not have to be that way. Instead, you could use your smartphone to get rapid test results from one drop of blood, monitor your vital signs both day and night, and use an artificially intelligent algorithm to receive a diagnosis without having to see a doctor, all at a small fraction of the cost imposed by our modern healthcare system. The change is powered by what Topol calls medicine's "Gutenberg moment." Much as the printing press took learning out of the hands of a priestly class, the mobile internet is doing the same for medicine, giving us unprecedented control over our healthcare. With smartphones in hand, we are no longer beholden to an impersonal and paternalistic system in which "doctor knows best." Medicine has been digitized, Topol argues; now it will be democratized. Computers will replace physicians for many diagnostic tasks, citizen science will give rise to citizen medicine, and enormous data sets will give us new means to attack conditions that have long been incurable. Massive, open, online medicine, where diagnostics are done by Facebook-like comparisons of medical profiles, will enable real-time, real-world research on massive populations. There's no doubt the path forward will be complicated: the medical establishment will resist these changes, and digitized medicine inevitably raises serious issues surrounding privacy. Nevertheless, the result-better, cheaper, and more human health care-will be worth it. Provocative and engrossing, The Patient Will See You Now is essential reading for anyone who thinks they deserve better health care. That is, for all of us.
Author: James Morss Churchill
Publisher: BoD – Books on Demand
ISBN: 3734043735
Category : Fiction
Languages : en
Pages : 42
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Book Description
Reproduction of the original: A Treatise on Acupuncturation by James Morss Churchill
Author: Danielle R. Bouchard
Publisher: Human Kinetics
ISBN: 1492592161
Category : Medical
Languages : en
Pages : 354
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Book Description
Go beyond aging theories and examine the physiological and physical impacts of aging. Exercise and Physical Activity for Older Adults takes a close look at the physical implications of the aging process and how health, physical activity, and exercise interact in aging adults. With an international team of contributors composed of leading experts from across the field of gerontology, Exercise and Physical Activity for Older Adults delivers comprehensive, interdisciplinary coverage of the physical aging process and its effects on movement and exercise. Research on the physiological and physical implications of aging is presented, focusing on study outcomes and their practical application in optimizing healthy aging. Presented in an integrated and cohesive manner, this text is organized into four parts. Part I covers the theoretical foundations of biological aging, the implications of aging theories on medical research, and the social and economic impacts of demographic shifts due to population aging and global population size. Part II addresses age-related changes to the musculoskeletal, cardiovascular, pulmonary, and endocrine systems. Part III covers the physical effects of aging on other dimensions of life, including balance, motor control, and physical functions. Part IV focuses on exercise and older adults, taking an in-depth look at exercise measurements and the main barriers to regular exercise. One full chapter is devoted to recommendations for optimizing health for the general public, while another chapter is focused on performance by elite older athletes who exercise beyond functional fitness. Chapter objectives, end-of-chapter summaries, and review questions highlight key concepts and promote learning retention. Behavior Check sidebars look at the impacts of aging on behavior, how behavior affects physical health and activity, and how changes in behavior can improve everyday living. Functional Fitness Checkup sidebars focus on the performance of daily movements that are vital for older adults who want to maintain their physical independence. Putting It Into Practice elements provide examples of real-life application of the concepts presented, facilitating a practical understanding of how to use the content to benefit clients. A definitive resource for students and health care professionals who study physical aging, conduct clinical research, or work with older adults as clients and patients, Exercise and Physical Activity for Older Adults helps readers understand the aging process and its effects on movement, exercise, and other dimensions of life.
Author: May Friedman
Publisher: Routledge
ISBN: 0429017634
Category : Social Science
Languages : en
Pages : 264
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Book Description
Thickening Fat: Fat Bodies, Intersectionality, and Social Justice seeks to explore the multiple, variable, and embodied experiences of fat oppression and fat activisms. Moving beyond an analysis of fat oppression as singular, this book will aim to unpack the volatility of fat—the mutability of fat embodiments as they correlate with other embodied subjectivities, and the threshold where fat begins to be reviled, celebrated, or amended. In addition, Thickening Fat explores the full range of intersectional and liminal analyses that push beyond the simple addition of two or more subjectivities, looking instead at the complex alchemy of layered and unstable markers of difference and privilege. Cognizant that the concept of intersectionality has been filled out in a plurality of ways, Thickening Fat poses critical questions around how to render analysis of fatness intersectional and to thicken up intersectionality, where intersectionality is attenuated to the shifting and composite and material dimensions to identity, rather than reduced to an “add difference and stir” approach. The chapters in this collection ask what happens when we operationalize intersectionality in fat scholarship and politics, and we position difference at the centre and start of inquiry.
Author: Kathrin Krohn
Publisher: Karger Medical and Scientific Publishers
ISBN: 380558606X
Category : Medical
Languages : en
Pages : 71
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Book Description
Parenteral nutrition in general is required if nutritional needs cannot be met by oral or enteral feeding. In the paediatric patient, its initiation depends both on individual circumstances and the age and size of the infant or child. This compact reference work on parenteral nutrition in children is based on the 'Guidelines for Paediatric Parenteral Nutrition' that have been developed jointly by the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the European Society for Clinical Nutrition and Metabolism (ESPEN), in collaboration with the European Society for Paediatric Research (ESPR).These guidelines were based on systematic literature reviews as well as a formal consensus process of a multidisciplinary panel of professionals. However, as a result of the scarcity of good quality clinical trials in children, many of the recommendations were extrapolated from adult studies and based on expert opinion. A detailed analysis of the available data was performed, and for each statement, the level of evidence and grade of recommendation was assessed. This reference guide has been conceived as an aid for the treating physician to assist him in the decision process, thus being a valuable companion in clinical practice.
